Search the hub
Showing results for tags 'Simulation'.
Found 54 results
-
Content ArticleFew areas of health policy have been untouched by the NHS structural turbulence of recent months, not least “place” and “neighbourhood” working. On the plus side, these parts of the system are at least used to performing without a script. London, for example, is pushing ahead with its own ambitious plan to explore the practicalities of implementing neighbourhood health across the city. Last week a “simulation” event trialling the plan for the capital was held. 100 participants acted out nine months of how the model might work in just a day and a half. In London, the 30-odd boroughs act as “places” within five integrated care boards. For each place, an “integrator” organisation is to be selected. The borough-level integrators could be trusts, councils, primary care providers, or even a partnership of several. They will host the functions needed to bring separate neighbourhood services and providers together, under the London NH vision. Would-be integrators were represented in London’s simulation, alongside acutes, community services, primary care, the London Ambulance Service, place leaders, voluntary services and residents representing a wide range of patient groups with complex needs. The simulation session was encouraging overall. But the growing pains of its first few hours also served as a reminder of what could go amiss in the real world.
-
Content ArticleAnaesthetic emergencies, though infrequent, pose a significant threat to patient safety. Simulation-based training offers participants the opportunity to immerse themselves in safe, realistic clinical scenarios, allowing them to hone their skills without risking patient harm. For the educator, the challenge lies in balancing the vast array of emergencies to be taught with limited resources available. This study explored whether focusing on transferable skills, specifically human factors, can improve confidence in managing these emergencies.
-
EventuntilRegister
-
Content Article
Dr Kirsten Howson, Specialist Education Lead at SimComm Academy, discusses the role Simulation-Based Education (SBE) can have in patient safety. Kirsten highlights some of the techniques used in SBE, the benefits for staff and patients, and the importance of involving people with lived experience in the design and delivery of SBE. Background Initially used within the aviation industry, Simulation-Based Education (SBE) has now been adopted within healthcare education and training.[1] Clinical SBE began several decades ago[2] and has continued to successfully grow, providing learners with the opportunity to put their knowledge and skills into practice within a psychologically safe environment. Effective SBE includes a debrief following on from the simulated exercises. Research outlines that the debrief has been identified as a key component of impactful SBE, with the simulated scenarios acting as a catalyst for further reflection, conversation and sharing of experiences and ideas.[3] There are a range of techniques used within SBE: Forum theatre: Participants observe a complete simulated scenario played out in front of them, followed by a group reflection. The scenario is then run again, giving participants the opportunity to pause the scenario at multiple points and change the behaviours and language of one of the simulated characters in an attempt to improve the outcome of the interaction. Fishbowl simulation: Participants are given a scenario and task and interact with simulated characters while their peers observe the interaction and completion of the task. This is followed by a facilitated debrief in which participants are able to explore alternative methods, obtain feedback, discuss learning objectives, and reflect and share ideas. Observational simulation: Participants observe a simulated scenario which is then followed by a facilitated debrief in which participants are able to explore alternative methods, discuss learning objectives, and reflect and share ideas. Monologues: Participants observe while a simulated character delivers a monologue, which may include the character’s reflections, experiences or feelings. This is then followed by a facilitated debrief in which participants are able to explore alternative methods, discuss learning objectives, and reflect and share ideas. How simulation-based education impacts on patient safety SBE has been shown to have a wide range of benefits, many of which impact on patient safety, including: Participant skills and knowledge: SBE enhances participant skills[4] through practice, reflection and feedback, and can span not only technical skills, such as performing procedures and examinations, but also non-technical skills, such as leadership, communication skills, teamwork or prioritisation.[5] Enhancement of the skills and knowledge of clinical staff will likely result in an increase in patient safety. Participant confidence: Simulation training can increase the participant's confidence by providing participants with the opportunity to practise a new skill in a simulated setting in which there will be no safety implications; participants can build their confidence to the point at which they feel safe to use the skills in a non-simulated environment.[6] Participant teamwork: Teamwork skills are often a key focus and improve through the use of simulation training.[7] Dependent on the participant group, this can be on both an intraprofessional and interprofessional basis. Although these skills can be practised within the simulation scenarios, the debrief period also provides the opportunity to share differing points of view within the team, which can enhance teamwork, and again will likely result in an increase in patient safety. Participant mental health, burnout and sick leave: Medical and allied healthcare staff face high levels of mental health concerns and burnout, with the recent General Medical Council (GMC) report, 'The State of Medical Education and Practice in the UK Workplace Experience 2024' stating, “a third of doctors are struggling and feel unable to cope.”[8] Staff burnout impacts negatively on patient safety.[9] Simulation training has been found to have beneficial effects on anxiety, stress and burnout among some staff groups[10] and could also act as a protective factor against sick leave.[11] The importance of co-design and co-production in simulation-based education In 'Learning from Experience', The Royal College of Psychiatrists states, “The involvement of people with lived experience of mental illness either as a patient or carer in educational programmes can provide unique and relevant learning opportunities and teaching experience for doctors and psychiatrists in training.”[12] The GMC have also outlined the patient role within education in 'Patient and Public Involvement in Undergraduate Medical Education.[13] We believe that this concept should be extended across healthcare education. We endeavour to include the perspectives of a range of people with lived experience in the design and delivery of our courses, such as members of staff, parents, relatives, carers and patients where possible and appropriate. Not only does this enrich the quality of the education, bringing a broader perspective, but it also carries benefits to the patients involved, including a sense of fulfilment.[14][15] Some examples of the methods of co-design, co-delivery and stakeholder involvement we have used in our training, include The involvement of one of our Equity and Inclusivity Advisors, who is also a member of the transgender and gender diverse community, in co-design and co-delivery of courses aimed at exploring and outlining the challenges and assumptions that LGBTQIA+ individuals face. The incorporation of staff reflections and experiences into scenarios when designing courses on the following topics:: - cultural allyship - fostering workplace belonging - Band 5 and 6 leadership - managing disability - supporting internationally educated nurses. The incorporation of patient and carer feedback and experiences when designing our course, 'What Matters to Me'. The incorporation of parent experience when designing filmed training scenarios surrounding communication with parents during neonatal resuscitation. You can read more about one of our co-design projects in 'Involving patients and relatives by translating their experiences into simulation-based education'.[16] Conclusions SBE is now widely used across healthcare training to a variety of multi-disciplinary professionals, within a range of specialities, covering both technical and non-technical skills, which demonstrates the degree of versatility of SBE. It is important to incorporate the voice and perspective of people with lived experience where possible to ensure authenticity. This is an extremely exciting time for SBE as new innovative methods, uses and programmes are developed with the ultimate aim of continuing to enhance patient safety. References Oman S P, Magdi Y, Simon L V. Past Present and Future of Simulation in Internal Medicine. In StatPearls. StatPearls Publishing, 2023. Nehring WM, Lashley FR. Nursing Simulation: A Review of the Past 40 Years. Simulation & Gaming, 2009; 40(4): 528-2. Jaye P, Thomas L, Reedy G. 'The Diamond': a structure for simulation debrief. The Clinical Teacher 2015; 12(3): 171–5. Issenberg SB, et al. Simulation technology for health care professional skills training and assessment. JAMA 1999; 282(9): 861–6. Pearson E. McLafferty I. The use of simulation as a learning approach to non-technical skills awareness in final year student nurses. Nurse Education in Practice 2011; 11(6):399–405. Alrashidi N, et al. Effects of simulation in improving the self-confidence of student nurses in clinical practice: a systematic review. BMC Medical Education 2023; 23(1); 815. Gilfoyle E, et al. & Teams4Kids Investigators and the Canadian Critical Care Trials Group. Improved Clinical Performance and Teamwork of Pediatric Interprofessional Resuscitation Teams With a Simulation-Based Educational Intervention. Pediatric Critical Care Medicine 2017; 18(2): e62–9. General Medical Council. The State of Medical Education and Practice in the UK Workplace experience, 2024. Garcia CL, et al. Influence of Burnout on Patient Safety: Systematic Review and Meta-Analysis. Medicina (Kaunas, Lithuania) 2019; 55(9): 553. Couarraze S, et al. Short term effects of simulation training on stress, anxiety and burnout in critical care health professionals: before and after study. Clinical Simulation in Nursing 2023; 75: 25–32. Schram A, et al. Exploring the relationship between simulation-based team training and sick leave among healthcare professionals: a cohort study across multiple hospital sites. BMJ Open 2023; 13(10): e076163. The Royal College of Psychiatrists. Learning From Experience. Working In Collaboration With People With Lived Experience To Deliver Psychiatric Education, May 2021. General Medical Council. Patient and Public Involvement in Undergraduate Medical Education, February 2011. Dijk SW, Duijzer EJ, Wienold M. Role of active patient involvement in undergraduate medical education: a systematic review. BMJ Open, 2020;10(7): e037217. Gutteridge R, Dobbins K. Service user and carer involvement in learning and teaching: a faculty of health staff perspective. Nurse Education Today, 2010; 30(6): 509–14. Hamilton CJ, et al. Involving patients and relatives by translating their experiences into simulation-based education. A31. Abstract from Association for Simulated Practice in Healthcare Annual Conference 2018, Southport, United Kingdom. -
Event
South East SimNet Conference 2025
Patient Safety Learning posted an event in Community Calendar
Join the 4th South East SimNet Conference, exploring national strategies, regional insights, and innovative approaches to simulation-based education in healthcare. Highlights include interactive workshops on mental health, moulage, technical skills, and primary care, inspiring keynote sessions, and engaging presentations from simulation fellows showcasing their transformative projects. Connect with industry partners, collaborate with peers, and discover new ways to enhance faculty development and patient safety education. Register -
News Article
Fake wounds help nurses raise pressure ulcer awareness
Patient Safety Learning posted a news article in News
Nurses hoping to reduce the rate of pressure ulcers in their hospitals are using a mannequin and self-made fake wounds to help teach colleagues about spotting and treating tissue damage in their patients. The training has been led by the clinical nurse educator, simulation and tissue viability teams at Hull University Teaching Hospitals NHS Trust and Northern Lincolnshire and Goole NHS Foundation Trust, which work together under the NHS Humber Health Partnership. Members of the teams have toured wards at Hull Royal Infirmary and Castle Hill Hospital with a model of a bottom covered with fake pressure ulcers. Kirsty Stephenson, a nursing simulation fellow based in the clinical skills building at Hull Royal Infirmary, said: “People learn in different ways and seeing what an ulcer actually looks like rather than a photograph in a textbook can help staff identify exactly what they’re looking for in patients.” Angie Oswald, lead nurse for tissue viability, based at Hull Royal Infirmary, said the clinical simulation exercise had been invaluable in her team’s work to reduce the number of pressure ulcers in patients at both hospitals. She said: “Clinical simulation is a fantastic teaching tool and offers clinical staff the chance to learn in a safe environment. “Using the mannequins and the moulage helps them familiarise themselves with what they should be looking for if a patient does develop a pressure ulcer and what steps they can take to stop it getting worse.” Read full story Source: Nursing Times, 17 January 2025 -
Content ArticleIdentifying high and poorly performing organisations is common practice in healthcare. Often this is done within a frequentist inferential framework where statistical techniques are used that acknowledge that observed performance is an imperfect measure of underlying quality. Various methods are employed for this purpose, but the influence of chance on the degree of misclassification is often underappreciated. Using simulations, this study shows that the distribution of underlying performance of organisations flagged as the worst performers, using current best practices, was highly dependent on the reliability of the performance measure. When reliability was low, flagged organisations were likely to have an underlying performance that was near the population average. Reliability needs to reach at least 0.7 for 50% of flagged organisations to be correctly flagged and 0.9 to nearly eliminate incorrectly flagging organisations close to the overall mean. The authors conclude that despite their widespread use, techniques for identifying the best and worst performing organisations do not necessarily identify truly good and bad performers and even with the best techniques, reliable data are required.
-
Content ArticleAuthors of this study, aim to describe the development of a post-simulation reflective learning conversations model in which a number of contributing factors to achieve clinical reasoning optimization were addressed.
-
Content ArticleSimulations are routinely used to identify latent safety threats. This article describes the classification of 1,318 latent safety threats identified from 232 simulations. Researchers were then able to issue site-specific and organisation-wide standardised dashboards and summaries, thus allowing for local and systemwide improvements.
-
Content Article
Simulation for non-pedagogical purposes has begun to emerge. Examples include quality improvement initiatives, testing and evaluating of new interventions, the co-designing of new models of care, the exploration of human and organisational behaviour, comparing of different sectors and the identification of latent safety threats. However, the literature related to these types of simulation is scattered across different disciplines and has many different associated terms, thus making it difficult to advance the field in both recognition and understanding. This paper, therefore, aims to enhance and formalise this growing field by generating a clear set of terms and definitions through a concept taxonomy of the literature. -
Content ArticleIn this blog, interdisciplinary humanistic, systems and design practitioner Dr Stephen Shorrock explores the dangers of project leaders relying on assumptions about work-as-imagined, detached from the reality of contextualised work-as-done. He describes his experience working on a project in which he discovered that operational staff felt anxious and unprepared for the major changes to come. This was unacknowledged by management, and he ascribes their lack of awareness to a failure to physically and empathetically engage with the workers in the reality of the processes and systems management had designed. He highlights the importance of empathy and asks the question, "In your worlds, how connected are managers and other non-operational specialists with operational staff and the operational environment, where changes ultimately end up? Those who wish to support operational staff through change must take the role of pupil, or apprentice – not master."
-
Content ArticleSimulation is traditionally used to reduce errors and their negative consequences. But according to modern safety theories, this focus overlooks the learning potential of the positive performance, which is much more common than errors. The authors of this article describe the learning from success (LFS) approach to simulation and debriefing. Drawing on several theoretical frameworks, they suggest supplementing the widespread deficit-oriented, corrective approach to simulation with an approach that focuses on systematically understanding how good performance is produced in frequent simulation scenarios.
-
EventuntilThis year’s conference theme has been selected to help all of us focus on becoming more mindful of how we develop, use and succession plan within our healthcare simulation services. We want to focus on sustainability to help support quality in simulation activity that enhances patient and team safety. This means we need to think about how we undertake service and learning needs analyses, how we plan our training and how to invest in our resources including staff, patients and colleagues, networking and educational equipment and software. And how we build our knowledge base, through the use of simulation as a research tool. The really exciting part is that you are invited to join the ASPiH through abstract submissions to share your work, and by attending and joining in the conference events including keynote presentations and breakout sessions. The conference content and discussions will shape additional conversations that will form future healthcare simulation practices amongst the ASPiH network and beyond. Register
-
EventuntilA triennial event featuring over 200 sessions all available on demand plus 800 papers on over 30 themes from healthcare ergonomics, organisational design and management to biomechanics and human modelling and simulation. The Executive Panel will address the Congress theme "HF/E in a Connected World" which raises urgent scientific and professional challenges concerning human interaction with technology in the era of automated and ubiquitous cyber-physical technologies. Register
-
Event
Simulation in healthcare incident investigation
Sam posted an event in Community Calendar
untilThe NHS standards for patient safety investigation recognise a need to better train and professionalise incident investigation in the NHS. Simulation is commonly utilised to improve the technical and non-technical skills of clinical staff in the NHS and forms part of professional investigation training and practise within other safety critical industries. A scoping review has considered what published work exists in commenting on the use of simulation as a training or practical tool in healthcare incident investigation. There may now be opportunities for healthcare incident investigation to learn from clinical colleagues, and professional investigation colleagues in other safety critical industries, to utilise simulation to help professionalise incident investigation in the NHS. Further information -
Community PostHi I have been working in a presentation we are giving at ASPiH in November around the work we have done using simulation to test systems and processes. we have done this in two ways. Firstly as a by-product of an educational in situ simulation in s clinical environment where a latent threat has been identified. In this case we will work with the area in looking at just what contributes to the threat and ways that may help. The second way (and with my HF head on, more exciting) has been setting out to test a process. We have done this several times now and have had some real successes in demonstrating the work as done v work as imagined theory. has anyone else used simulation in this way? looking forward to your replies. Phil
-
News ArticleA new training aid, developed in Fife, is helping to equip trainee medical staff from around the world with the skills to prevent late miscarriage and premature labour. It was invented by Dr Graham Tydeman, consultant in obstetrics and gynaecology at Kirkcaldy’s Victoria Hospital, in conjunction with the St Thomas’ Hospital, London, and Limbs and Things. The lifelike simulator allows trainees to perform hands on cervical cerclage in advance of a real-life emergency. The procedure involves an emergency stitching around the cervix and is necessary when the cervix shortens or opens too early during pregnancy, helping to prevent late miscarriage or extreme premature labour. It is not a common event and the simulator was developed by Dr Tydeman following a request from medical trainees across the UK. The device has already been warmly received by hospitals and training institutions across the world – with orders from countries including New Zealand and India. Dr Tydeman said: “The reason this was developed is that it is not a common procedure and is very difficult to teach trainees." “Increasingly women are understandably asking about the experience of their surgeon and anyone having this procedure understandably does not want it to be the first one that a doctor has ever done because if it goes wrong there could be tragic consequences with loss of the baby. However, if a trainee has shown suitable skills using this simulator, I would be able to confidently reassure women that the doctor had been adequately trained, although a more experienced person would always help during the actual operation for the first few procedures on real women." Read full story Source: The Courier, 19 December 2020
-
Content ArticlePatient safety is the number one priority in health care as safety is considered at every level of a healthcare organisation (e.g., building, equipment, communication, processes for medications, treatments, and surgical procedures). Addressing the welfare of patients can be challenging, yet for some of the most vulnerable patients (e.g., special needs, disabilities and mental and social health issues), even the most routine nursing requests can put them at a safety risk. Simulations provide an opportunity for nursing students and professional nurses with realistic experiences caring for individuals with unique needs, especially when safety is a major concern.
-
Content ArticleThis systematic review and meta-analysis from Mazzone et al. confirms that proficiency-based progression training in comparison to conventional or quality assured training improved trainees' performances, by decreasing procedural errors and procedural time, while increasing the number of correct steps taken when compared to standard simulation-based training.
-
Content ArticleThis article, published in Simulation and Gaming proposes a strategy for ensuing simulation training following the implementation of a thorough Team Strategies and Tools to Enhance Performance and Patient Safety (TeamSTEPPS®) training initiative. The strategies include observing Teams in the workplace to facilitate the construction of organisation-wide, follow-on simulation training.
-
Content Article
Intensive Care bed space orientation
Claire Cox posted an article in Other health and care software
This interactive orientation of an Intensive Care Unit (ICU) bed space, created by the London Transformation and Learning Collaborative, is ideal for healthcare professionals new to the ICU environment. It allows you to explore the risks and demonstrated the safety check required to keep patients safe in the ICU. This application is best used with a smart phone, but can be used on a computer. -
Content ArticleIn this 30 minute video presentation, we hear from Dr Victoria Brazil, Professor of Emergency Medicine and Director of Simulation, Gold Coast Health Service. Dr Brazil talks through the benefits and complexities of simulation training using real life footage to illustrate key points. She suggests there are three ways healthcare can be improved using simulation: Simulation to explore Simulation to test Simulation to embed.
-
Content ArticleThis study from Sanko et al., published in Simulation in Healthcare, found that improvements in systems thinking increase adverse event (AE) reporting patterns among undergraduate nursing students participating in a simulation exercise. The authors suggest that prelicensure training include reinforcement of systems thinking principles to achieve patient safety improvements.
-
Content ArticleUser-testing and subsequent modification of clinical guidelines increases health professionals’ information retrieval and comprehension, but no study has investigated whether this results in safer care. Jones et al. compared the frequency of medication errors when administering an intravenous medicine using the current National Health Service Injectable Medicines Guide (IMG) versus an IMG version revised with user-testing. Participants were on-duty nurses/midwives who regularly prepared intravenous medicines. Using a training manikin in their clinical area, participants administered a voriconazole infusion, a high-risk medicine requiring several steps to prepare. They were randomised to use current IMG guidelines or IMG guidelines revised with user-testing. The results, published in BMJ Safety & Quality, found that fewer moderate-severe IMG-related errors occurred with the user-tested guidelines compared with current guidelines, but this difference was not statistically significant. Significantly more simulations were completed without any IMG-related errors with the user-tested guidelines compared with current guidelines. Participants who used user-tested guidelines reported greater confidence. The authors conclude that user-testing injectable medicines guidelines reduces the number of errors and the time taken to prepare and administer intravenous medicines, while increasing staff confidence.
-
Content ArticleThe COVID-19 pandemic is challenging the Canadian emergency departments (EDs) in unparalleled ways. As part of the frontline response, EDs have had to adapt to the unique clinical difficulties associated with the constant threat of COVID-19, developing protocols and pathways in the setting of limited and evolving information. In addition to the disruption of routine clinical care practices, an underlying perception of danger has resulted in a challenging clinical environment in which to make time-sensitive, high-stakes decisions. This has created an urgent need for targeted and adaptive training for all members of the emergency medicine healthcare team. The following commentary, published here by the Cambridge University Press, reflects the perspective of four emergency medicine simulation educators during the Canadian response to COVID-19.
